| NPI | 1558960831 |
|---|---|
| Former Name | KOURTNEY LYNN WATHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 10043) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: DC SLP200001316) |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2025-01-13 |